{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T15:17:43Z","timestamp":1793287063961,"version":"4.5.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T00:00:00Z","timestamp":1709510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Jesse B. Jupiter Research Fund of the Wyss Medical Foundation."}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>We assessed factors associated with change in radiographic teardrop angle following volar locking plate (VLP) fixation of volarly displaced intra-articular distal radius fractures with volar ulnar fragments (VUF) within the ICUC database. The primary outcome was change in radiographic alignment on follow-up imaging, defined as a change in teardrop angle from intra-operative fluoroscopy greater than 5\u00b0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients with distal radius fractures treated with a VLP within the ICUC database, an international collaborative and publicly available dataset, were identified. The primary outcome was volar rim loss of reduction on follow-up imaging, defined as a change in radiographic alignment from intra-operative fluoroscopy, teardrop angle less than 50\u00b0, or loss of normal radiocarpal alignment. Secondary outcomes were final range of motion (ROM) of the affected extremity. Radiographic Soong classification was used to grade plate position. Descriptive statistics were used to assess variables\u2019 distributions. A Random Forest supervised machine learning algorithm was used to classify variable importance for predicting the primary outcome. Traditional descriptive statistics were used to compare patient, fracture, and treatment characteristics with volar rim loss of reduction. Volar rim loss of reduction and final ROM in degrees and as compared with contralateral unaffected limb were also assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Fifty patients with volarly displaced, intra-articular distal radius fractures treated with a VLP were identified. Six patients were observed to have a volar rim loss of reduction, but none required reoperation. Volar ulnar fragment size, Soong grade 0, and postfixation axial plate position in relation to the sigmoid notch were significantly associated (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05) with volar rim loss of reduction. All cases of volar rim loss of reduction occurred when VUF was 10.8 mm or less.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The size of the VUF was the most important variable for predicting volar rim loss of reduction followed by postfixation plate position in an axial position to the sigmoid notch and the number of volar fragments in the Random Forest machine learning algorithm. There were no significant differences in ROM between patients with volar ulnar escape and those without.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15589447241233762","type":"journal-article","created":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T02:33:12Z","timestamp":1709605992000},"page":"748-754","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Teardrop Alignment Changes After Volar Locking Plate Fixation of Distal Radius Fractures With Volar Ulnar Fragments"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0149-608X","authenticated-orcid":false,"given":"Justin C.","family":"McCarty","sequence":"first","affiliation":[{"name":"Hand &amp; Arm Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, USA"},{"name":"Department of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4939-8796","authenticated-orcid":false,"given":"Rachel E.","family":"Cross","sequence":"additional","affiliation":[{"name":"Hand &amp; Arm Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, USA"},{"name":"Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0520-1851","authenticated-orcid":false,"given":"Charlotte L. E.","family":"Laane","sequence":"additional","affiliation":[{"name":"Hand &amp; Arm Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, USA"},{"name":"Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0907-1553","authenticated-orcid":false,"given":"Yannick Albert J.","family":"Hoftiezer","sequence":"additional","affiliation":[{"name":"Hand &amp; Arm Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, USA"},{"name":"Department of Plastic, Reconstructive and Hand Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aquiles","family":"Gavagnin","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Hospital Britanico Montevideo, Uruguay"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Regazzoni","sequence":"additional","affiliation":[{"name":"University Hospital Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Fernandez Dell\u2019Oca","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Hospital Britanico Montevideo, Uruguay"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse B.","family":"Jupiter","sequence":"additional","affiliation":[{"name":"Hand &amp; Arm Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhiram R.","family":"Bhashyam","sequence":"additional","affiliation":[{"name":"Hand &amp; Arm Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,3,4]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3182231af9"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1685205"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.3109\/17453674.2013.792035"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-021-01679-z"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-022-02825-x"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1675792"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.20.00022"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/1753193413511936"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000006636"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1667304"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2010.09.033"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.17.00107"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-020-02700-8"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2017.01.045"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/os.13409"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-012-2767-8"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.5312\/wjo.v9.i10.203"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jor.2020.11.007"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2012.10.012"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2006.01.011"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2011.10.056"},{"key":"e_1_3_2_23_2","unstructured":"ICUC database. https:\/\/www.icuc.net\/. 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Sensibilite et specificite de l\u2019amylasemie, du rapport des clairances d\u2019amylase et de creatinine et du rapport amylasurie\/creatininurie pour le diagnostic des pancreatites aigues [Sensitivity and specificity of blood amylase, amylase and creatinine clearance ratio and urinary amylase\/urinary creatinine ratio in the diagnosis of acute pancreatitis]. 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